Medical Plans
Eligible faculty and staff members can choose from several plan options. Learn more about the options available to you, rates, coverage and resources provided by each plan.
Eligibility
You must be full-time benefits eligible (37.5 scheduled hours per week) or part-time benefits eligible (at least 17.5 scheduled hours per week) to enroll in medical plans. Shuttle drivers and members of the Campus Police Association must be scheduled to work 40 hours per week to be full-time benefits eligible.
Medical Plan Options
View the Medical Coverage Comparison Chart and Medical Plan Resources for more information.
Plan Type |
Description |
Preferred Provider Organization (PPO) |
PPO plans give you the flexibility to use in- or out-of-network providers without referrals. A higher level of benefits is provided when in-network providers are used, resulting in lower out-of-pocket costs for you.
|
Health Maintenance Organization (HMO) / Exclusive Provider Organization (EPO) |
HMO/EPO plans have low out-of-pocket expenses (no deductible or coinsurance) but do not provide benefits if you use out-of-network providers (except in the case of an emergency). Referrals to specialist care and related services are not required in most circumstances.
|
High Deductible PPO with Health Reimbursement Account |
High-Deductible PPO plans have a higher deductible and a lower monthly premium. CMU funds a Health Reimbursement Account (HRA) that you can use to help pay for eligible deductible expenses. Once your health care expenses for the year exceed your deductible, the PPO plan begins paying benefits.
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Medical Plan Summaries
Highmark Blue Cross Blue Shield
UPMC
Medical Plan Contacts and Provider Search Tools
Highmark Blue Cross/Blue Shield
- Phone: 800-472-1506 (in Western PA); 800-810-2583 (outside Western PA)
- Highmark Provider Search: For PPO plans, search "PPOBlue." For the EPO plan, search "BCBS EPO."
- Outside of Western PA — For PPO plans, search "BCBS PPO;" refer to the Out of Area Provider Search instructions [pdf]. For the EPO plan, search "BCBS EPO."
- View Highmark's Find In-Network Doctors flyer [pdf] for more information.
UPMC Health Plan
- Phone: 855-497-8762
- UPMC Provider Search — Enter your member ID to search by plan. Non-members can use the "I'm just browsing" tab to browse by provider type and location. For PPO plans, use "Premium Network." For the HMO plan, use "Enhanced Access Network."
- Outside of Western PA — Search the extended network; refer to the Out of Area Provider Search instructions [ppsx].
- View UPMC's Provider Search Tool flyer [pdf] for more information.